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Archived: Dell Field Court Good

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Reports


Inspection carried out on 22 March 2019

During a routine inspection

About the service

Dell Field Court is a care home for older people with learning difficulties, dementia and physical frailty. The home has 40 beds and is on three floors; each floor has its own dining area and lounge, The second-floor unit was dedicated to people from Asian origin. On the day we inspected there were 36 people living in the home.

People’s experience of using this service

People were very happy living at the home because they felt safe and all their needs were met by kind and caring staff. Relatives were pleased with the service provided to their family members and staff enjoyed working at the home.

Everyone we spoke with praised the registered manager and agreed that they were approachable, knowledgeable, fair and did their job well. A staff team who worked well together supported the registered manager. The provider employed enough staff to make sure people’s needs were met in a timely way. The provider had designed a recruitment process to make sure they only employed suitable staff.

The staff team was committed to providing a high-quality service and keeping people safe. They had undertaken training in a wide range of topics so that they were skilled and knowledgeable to effectively meet people’s needs. Staff understood their responsibilities to report any concerns.

Staff encouraged people to be as independent as possible and respected people’s privacy and dignity. All staff welcomed relatives and visitors warmly and treated them as part of ‘the family’.

Staff knew people well. They followed the guidelines in each person’s care plan so that they delivered care and support in the way each person wanted. Staff managed the risks to people’s health and welfare well.

The home was clean, fresh and hygienic. Staff used effective infection control measures to protect people from the spread of infection. Equipment was available when needed to help staff support people in a safe way.

The service had appropriate documentation in place in relation to consent and compliance with the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Two activities coordinators organised a range of things for people to do. The home provided nutritious meals and external healthcare professionals supported people to maintain their health.

The registered manager actively sought the views of people and their relatives about the running of the home and they dealt promptly with any concerns that people raised.

The provider had a thorough system in place to monitor and improve the quality and safety of the service provided.

More information is in the full report.

Rating at last inspection

At the last inspection we rated this service Good. The report was published on 24 January 2017.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

Going forward we will continue to monitor this service and plan to inspect in line with our re-inspection schedule for those services rated Good.

Inspection carried out on 24 January 2017

During an inspection to make sure that the improvements required had been made

We carried out an unannounced comprehensive inspection of this service on 13 September 2016. At which a breach of legal requirement was found. We found that there was not a sufficient number of staff available to meet people’s needs.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to this breach.

We undertook a focused inspection on the 24 January 2017 to check that they had followed their plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Dell Field court on our website at www.cqc.org.uk.

Dell Field Court is a care home for older people with learning difficulties, dementia and physical frailty. The home has 40 beds split into three floors; each floor has its own dining area and lounge, the second floor unit was dedicated to people from Asian origin. On the day we inspected there were 35 people living in the home.

The home has a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

At our focused inspection on the 24 January 2017, we found that the provider had followed their plan and legal requirements had now been met.

We found that the provider had employed additional care staff and the use of agency staff had been reduced, staff had been deployed appropriately to meet people’s needs.

Inspection carried out on 13 September 2016

During a routine inspection

Dell field Court is a care home for older people with learning difficulties, dementia and physical frailty. The home has 40 beds split into three floors; each floor has its own dining area and lounge, the second floor unit was dedicated to people from Asian origin. On the day we inspected there were 37 people living in the home.

There was a registered manager in post. A registered manager is a person who has registered with Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

Most people were positive about the service and the staff who supported them. People told us they liked the staff that supported them and that they were treated with dignity and kindness.

Staff treated people with respect and as individuals with different needs and preferences. Staff understood that people’s diversity was important and something that needed to be upheld and valued. The care records contained detailed information about how to provide support, what the person liked, disliked and their preferences. People who used the service along with families and friends had completed a life history with information about what was important to people. The staff we spoke with told us this information helped them to understand the person.

The care staff demonstrated a good knowledge of people’s care needs, significant people and events in their lives, and their daily routines and preferences. They also understood the provider’s safeguarding procedures and could explain how they would protect people if they had any concerns.

However there were insufficient numbers of suitably qualified, skilled and experienced staff to care for the number of people with complex needs in the home. There was a high usage of agency staff and people told us they often had to wait for assistance. Staff told us that during busy periods they did not have enough time to spend with people.

Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. Medicines were managed safely. Staff had detailed guidance to follow when administering medicines. Staff completed extensive training to ensure that the care provided to people was safe and effective.

There was an open and transparent culture and encouragement for people to provide feedback. The provider took account of complaints and comments to improve the service. A complaints book, policy and procedure were in place. People told us they were aware of how to make a complaint and were confident they could express any concerns and these would be addressed.

CQC monitors the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and reports on what we find. DoLS are a code of practice to supplement the main Mental Capacity Act 2005. These safeguards protect the rights of adults by ensuring that if

there are restrictions on their freedom and liberty these are assessed by appropriately trained professionals. The manager had knowledge of the MCA 2005 and DoLS legislation and appropriate referrals for DoLS authorisation had been made so that people’s rights would be protected.

The management team provided good leadership and people using the service, relatives and staff told us they were approachable, visible and supportive. We saw that regular audits were carried out by the provider’s head office to monitor the quality of care.

Care staff received regular supervision and appraisal from their manager. These processes gave staff an opportunity to discuss their performance and identify any further training they required. Care staff placed a high value on their supervision.

The provider employed a leisure and lifestyle lead who organised a range of activities that provided entertainment and stimulation for p

Inspection carried out on 30 October 2013

During a routine inspection

We spoke to staff, residents and relatives during our inspection. People told us about the care they received, described how they were treated by staff, how they felt about the way they were communicated with and consulted. We observed interactions between staff and people who use the service, as well as talking to mangers and staff who work in the home. In addition to this we examined documentation concerning how staff were trained and what care they were providing to people who use the service. We observed staff treating people with dignity and respect and making sure the care they gave was individualised appropriately.

We looked at how staff were trained and whether information given in training at staff meetings was being used to improve the care. we found that staff had been trained in and understood how to safeguard vulnerable people from abuse.

The premises were found to have been safely maintained and arrangements were in place to monitor the environment.

Staff were supported to develop their skills and a strong system of appraisal was used to monitor staff performance.

People told us that staff were always courteous and friendly and that they felt they could talk to senior staff if they had concerns. Comments included ‘they do exactly what I need’ and ‘I feel safe and well cared for here’. People also told us that they felt their cultural needs were being met and that they were able to fully enjoy celebrating their important religious festivals.

Inspection carried out on 14 June 2012

During a themed inspection looking at Dignity and Nutrition

People told us what it was like to live in this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a Care Quality Commission (CQC) Inspector joined by an Expert by Experience; people who have experience of using services and who can provide that perspective.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk to us.

People who use the service told us that staff were always polite and they did not feel rushed. Staff knocked on doors before entering people’s rooms and they were treated with dignity and respect.

People told us that their views and preferences were taken into account when planning activities. Comments ranged from ‘we can do whatever we want either bingo, or a quiz or play cards or have a sing along.’ to ‘we all get together to celebrate and enjoy spending time in the garden and often have a barbeque.’

People told us that they were given choices about the food and drink provided at the home, and that their cultural needs were being met.

Inspection carried out on 18 April 2011

During a routine inspection

People using the service expressed satisfaction with the service and told us that

“It’s friendly, it’s very nice here” and that “I’m very happy here”.

They said that their visitors were made welcome when visiting the care home and they could entertain visitors in the privacy of their own room. People confirmed that when assistance with personal care was given their dignity and privacy was respected. They told us they were encouraged to be as independent as possible and to make decisions about how they spend their time. “You can join in the activities, if you want to”. People living in the rehabilitation unit were pleased with the progress they were making and with the equipment in use to help them regain their mobility and independence. “The handle on the frame of the bed helps me to get to a sitting position”.

Respect for religious and cultural needs was appreciated by people using the service. “We have Bhajans and then we have exercises”. People told us that they could make decisions and said “They let me choose”.

People told us that suggestions that they have made have been put into practice. They gave the recently established fortnightly film club as an example. People told us that card games, singing and painting were some of the activities taking place. Although most people who use the service were pleased with the activities that were arranged, one person said that they were bored. “There’s nothing to do. That’s why I am here (in their room)”.

Staff talked to people using the service and explained what they wanted to do before providing care. They were aware of the need to obtain consent and of the person’s right to refuse. Strategies were in place to gain consent in a manner that respected the dignity of the person using the service. People who used the service told us

“You know what’s going on” and “You know what they are doing”.

Although when speaking with people they were often unaware of their care or support plan they were satisfied with the care received and with the assistance given to enable them to maintain a healthy lifestyle. “They give me the help I need and want”.

When asked about the meals provided people told us

“The majority of the food is very nice. There is usually a choice of two main meals and a roast dinner on Sundays”.

“The meals are lovely. The cook is good. There is a good variety”.

They confirmed that “if you don’t like it they offer something else”. They agreed that portion sizes were good and said “You can have more if you want it”.

They told us that they were encouraged to drink plenty of fluids when the weather was hot.

People using the service told us that support is given so that they can access health care services within the community and that when they are ill “the office will call the GP for you”. A person said “The OT and physiotherapist come to see me”.

People told us that they felt safe living in the home and safe with the members of staff supporting them. Names were given of who they would speak to if they were worried about anything or if they were upset and these included the names of members of staff working on their unit e.g. the person’s key worker or one of the managers. Comments included

“Yes, I am safe”.

“I can talk to (name of member of staff given)”.

People living in the home told us that the home was kept clean. They said that

“It’s always kept clean” and that cleanliness was a consistent feature of both communal and private areas. Cleaning of these areas took place during our visit. Praise was given when talking about the domestics and the laundry service.

“If something needs doing I will tell the domestic”.

“There is a very good laundry service”.

The personal hygiene of people who use the service was good and contributed towards their self esteem and they looked clean and tidy.

When asked about the medication that people who use the service were taking they commented

“I take a couple of pills, calcium, I asked what they were for and they told me”.

However not everyone was aware of what the pills were for. Overall they were satisfied with receiving support and told us

“I’m happy for them to bring me my pills. I’d never remember. They watch until I swallow them”.

People told us that there was a homely atmosphere in Dell Field Court and that the two resident cats helped to create this. They appreciated their single bedrooms that had en suite facilities.

“It’s good having your own room and your own bathroom. It saves having to share”.

They were satisfied generally with their accommodation.

“I have a nice room with a good view from the window”.

They told us that the care home was “nice and warm” and said that their rooms were comfortable and sufficient in size.

“It’s one of the best Fremantle homes. It’s like a 5 star hotel”.

They confirmed that there was an ongoing maintenance programme and referred to painting, decorating and changing light bulbs.

People living in the Asian unit showed us the communal areas and bedrooms. Wall hangings, pictures, decorations and temples gave people an environment in which they felt comfortable and respected. People told us that members of staff were knowledgeable about their needs and there was a good rapport between members of staff and people using the service. They were comfortable in each others company and people told us that members of staff were competent and that “they know what they are doing”. Gujarati speaking people who use the service appreciated members of staff working in the Asian unit who spoke both Gujarati and English. Comments made about the staff team included

“They do everything you need”.

“The staff are very good”.

People told us that the members of staff were “polite and respectful”.

“The staff are very good. They are helpful, kind and caring”.

When asked whether there were sufficient carers on duty to meet their needs they told us “I think so” and “Yes, as far as I know”. They told us that at night

“The carers come quickly”.

The manager and an Asian resident greeted each other in Gujarati. Another resident said “she is the best manager”. People in all the units confirmed that the manager “is very nice. She comes around to see us”. People confirmed that they saw the manager when she visited the units, on a regular basis. She addressed people by name and was aware of any current concerns or problems that they might have. People told us that they were able to go to speak to someone if they had a matter that they wanted to discuss. Overall people were satisfied with the quality of the service provided and had not had cause to complain. They told us that

“I go to the residents’ meetings. They ask if there are any complaints and try to iron these out”.

“I’m always happy”.

Reports under our old system of regulation (including those from before CQC was created)